LOCAL SUPERVISING AUTHORITY (LSA) ANNUAL REPORT SUBMISSION TO THE NMC Northern Health & Social Services Board NORTHERN IRELAND 1 April 2005 31 March 2006 September 2006 1
Page No Contents 1 Forward by LSAMO 2 Supervision of Midwives 3 Annual Report 4 2
FOREWORD The Northern Health and Social Services Board (the Board) is the Local Supervising Authority (LSA) responsible for the function of statutory supervision of midwives. The LSA is accountable to the Nursing and Midwifery Council (NMC) who sets Rules and Standards for Midwifery. As part of this responsibility, the Board submits an Annual Report on the supervision of midwives to the NMC and ensures that the report is made available to the public. The protection of women and children through effective midwifery supervision is highlighted again in this year s report. This is reflected in the work done to incorporate the objectives of clinical and social care governance into midwifery supervisory practice and the improved access to midwifery supervisors. The LSA appointed a part-time, seconded LSA midwifery Officer (LSAMO) for three boards (Northern, Western & Southern Health and Social Services Boards) in January 2006. The Link Supervisor of Midwives and all the supervisors continue to contribute to clinical audit, standard setting, research and evidence based practice. Throughout the last year, the Nursing and Midwifery Council (NMC) have consulted extensively on a review of pre-registration midwifery education, Standards for the Preparation and Practice of Supervisors of Midwives and the development of a policy for overseas-trained midwives. The LSAMO and Supervisors of Midwives have contributed to all these consultations through a variety of forums. The LSAs, LSAMO, Link Supervisors and the Supervisors of Midwives are keen to continue the development of midwifery supervision, building on the good work already done. The Midwives Rules and Standards set out an agenda for change which will utilise the skills of the supervisors of midwives to develop the maternity services in the three board areas. I wish to acknowledge the work of the Board s Link Supervisor of Midwives, all of the supervisors of midwives and the commitment and support given by the Trusts and the Boards to their role. It is this partnership and effective supervision, embedded in practice that ensures the highest standards of care and best outcomes for mothers and babies. Verena Wallace LSAMO for the Northern, Western & Southern Health and Social Services Boards 3
Supervision of Midwifery All Midwives in the United Kingdom have a named Supervisor of Midwives. This is a statutory provision for the profession whether midwives practise in hospital, the community or privately. The role of the Supervisor of Midwives is only provided in the United Kingdom, no other country in the world has this professional support as statutory to the practice of midwifery. To become a Supervisor of Midwives requires extra study once a nomination and selection process has occurred. Supervisors are not appointed by employing Trusts although the majority of Supervisors of Midwives have a remit of work or a caseload of supervisees that are most often employed by the same organisation. Every midwife therefore comes under the supervision of a local supervising authority, geographic areas that are responsible for ensuring supervision is undertaken that meets the NMC standards. In Northern Ireland these areas are the Health and Social Services Boards. A woman can contact the Local Supervising Authority directly if she has concerns about access to midwife care or if she has concerns about standards of care that she has experienced. Most local supervising authorities employ local supervising authority midwifery officers to act on their behalf and to be an essential point of contact for midwives who seek guidance in relation to their practice or women who require information about local services. The officer provides leadership, support and guidance to Supervisors of Midwives who function within each respective authority and will give guidance to Trust Executives in relation to the provision of Midwifery Services in their hospitals. LSA Report This report follows the outline received from the NMC in June 2006 relating to the presentation required to fulfil rule 16 in the NMC s Midwives rules and standards, 2004. 4
Northern Health & Social Services Board Maternity Services in the Northern Health and Social Services Board Supervisors of Midwives supervise midwives in the Northern Health and Social Services Board (the Board) in the Trusts that provide maternity services. TRUSTS SERVICES LOCATION United HSST Causeway HSST Hospital Maternity Services Community Midwifery Service Integrated Hospital and Community Midwifery Services Antrim Area Hospital, Antrim; Mid Ulster Hospital, Magherafelt Ballymena, Antrim, Larne Causeway Hospital, Coleraine Coleraine, Ballycastle, Ballymoney 1. Each local supervising authority will ensure their report is made available to the public This report will be available in hard copy from the NHSSB. 2. Supervisor of Midwives Appointments, Resignations and Removals Appointments: 8 Resignations: 2 Removals: 0 An identified trend is an increase in the number of Supervisors of Midwives over the previous years. Number of Supervisors of Midwives in NHSSB 2003/4 2004/5 2005/6 8 11 17 3. How are midwives provided with continuous access to a supervisor of midwives? 24-hour access to a supervisor of midwives is not yet universal throughout the Board/LSA area. However a 24-hour supervision rota is provided when a risk has been identified e.g. a home birth outside the selection criteria that requires support or advice from the supervisor of midwives. 5
Discussions are ongoing to facilitate 24-hour supervision in 2006/7. 4. How is the practice of midwives supervised? Supervisors of midwives in the respective areas in the Board/LSA meet regularly and ensure allocation of a supervisor of midwives to every midwife who has notified her intention to practise within the Board s area. Each midwife is given an information leaflet with contact details of her own named supervisor of midwives and the names and contact details of all the supervisors of midwives in the Board/LSA area. Each midwife is invited to meet with her supervisor of midwives at least once each year. The midwife is advised that supervision is a continuous process and the midwife is encouraged to make contact with her supervisor of midwives for support or advice, at any time should the need arise. Some midwives did not meet with their supervisor of midwives in 2005/6 and the reasons for this are being assessed as it can be due to factors such as maternity leave. An action point for this year is to address this and minimise this number for 2006/7. Newly appointed midwives are allocated a supervisor of midwives as part of their induction process. More midwives undertaking the preparation of supervisor of midwives course has also raised awareness of supervision of midwives in all areas of the Board/LSA. In an effort to highlight supervision of midwives and in addition to the above processes, Trusts within the Board area are carrying out awareness sessions to raise the profile of supervision. 5. Service user involvement in monitoring supervision of midwives and assisting the local supervising authority midwifery officer with the annual audits No audits of practice took place during 2005/6. With the appointment of a part-time LSAMO in January 2006, the programme for annual audits will start in 2006 and service users will be involved wherever possible. 6. Engagement with higher education institutions in relation to midwifery education programmes Supervisors of midwives contribute to education programmes for midwives e.g. return to midwifery practice. Link supervisors of midwives meet with the representatives of the HEIs and NIPEC four times per year to discuss provision of future courses. Students are made aware of the role of the supervisor of midwives. Supervisors of 6
midwives have input to lectures and provide these for student midwives and midwives undertaking the preparation of supervisor of midwives course. 7. New policies related to the supervision of midwives Supervisors of midwives in Causeway H&SS Trust developed a strategy for supervision. They lectured on the supervisors of midwives course about their successful workshops on supervision that have been used to raise awareness of supervision amongst midwives. Within the Board area a new annual midwifery supervision review proforma was developed and will be piloted in 2006/7 During the period of this report preliminary work was undertaken to provide guidelines for the supervision of midwifery within the Board area. This work will be completed in the period 2006/7. Each supervisor of midwives will have a personal copy of the guidelines. Supervisors throughout the Board area are involved in the development of new maternity guidelines and policies. 8. Developing trends affecting midwifery practice in the LSA Supervisors of midwives continue to influence midwives in the provision of midwifery led services. Other areas of influence include the development of hand held maternity records, antenatal care pathways and the implementation of the Northern Ireland Maternity Information System (NIMATS). Causeway HSST undertook Birthrate Plus (workforce analysis) during 2005/6 and final results will be available in 2006/7. Clinical Activity 2005 2006 Hospital Live births Stillbirths Antrim Area Hospital 2374 6 Mid Ulster Hospital 663 4 Causeway 1147 4 Home births 8 0 Number of Maternal Deaths Antrim Area Hospital Mid-Ulster Hospital Causeway Hospital 0 0 0 7
Unit Closures 0 Independent external reviews Price Waterhouse Coopers carried out a regional Value for Money audit during 2005/6. Results will be available in 2006. The maternity service at the MidUlster will be withdrawn in late 2006. There were no midwifery supervision issues at the Mid Ulster. 9. Complaints regarding the discharge of the supervisory function There were no complaints regarding the discharge of the supervisory function. In January 2006 a part-time, seconded LSA midwifery officer was appointed for three Boards. This is seen as a positive contribution to midwifery supervision and aims to further develop the profile of midwifery supervision. 10. Local supervising authority investigations undertaken during the year There was one LSA investigation undertaken during the report year. Signature Chief Executive NHSSB:. Stuart MacDonnell Chief Executive NHSSB County Hall 182 Galgorm Road, Ballymena Co Antrim BT42 1QB Signature LSAMO NHSSB:.. Verena Wallace LSAMO c/o Maternity Unit, Causeway Hospital Newbridge Road, Coleraine BT52 1HS 8
Appendix 1 NMC Supervision of Midwives in the United Kingdom All Midwives in the United Kingdom have a named Supervisor of Midwives. This is a statutory provision for the profession whether midwives practise in hospital, the community or privately. The role of the Supervisor of Midwives is only provided in the United Kingdom, no other country in the world has this professional support as statutory to the practice of midwifery. To become a Supervisor of Midwives requires extra study once a nomination and selection process has occurred. Supervisors are not appointed by employing Trusts although the majority of Supervisors of Midwives have a remit of work or a caseload of supervisees that are most often employed by the same organisation. Trusts are also required to pay remuneration for various duties that the Supervisor of Midwives performs. Every midwife therefore comes under the supervision of a local supervising authority, geographic areas that are responsible for ensuring supervision is undertaken that meets the NMC standards. In England these areas are the Strategic Health Authorities; Northern Ireland - Health and Social Services Boards; Scotland Health Boards and Wales Health Care Inspectorate. Women can contact the Local Supervising Authority directly if she has concerns about access to midwife care or if she has concerns about standards of care that she has experienced. Each local supervising authority, employs local supervising authority midwifery officers to act on their behalf and to be an essential point of contact for midwives who seek guidance in relation to their practice or women who require information about local services. The officer provides leadership, support and guidance to Supervisors of Midwives who function within each respective authority and will give guidance to Trust Executives in relation to the provision of Midwifery Services in their hospitals. Reference NMC: www.nmc-uk.org. 25 August 2006 9